Agenda Item: 3.2.8. Prepared by: V. Ayars/J. Hooper/K ... · Systems, Incorporated (HESI) PN Exit...

Agenda Item: 3.2.8. Prepared by: V. Ayars/J. Hooper/K. Benton

Board Meeting: July 2017

Consideration of the Proposal to Establish a New Military Track Baptist Health System School of Health Professions in San Antonio, Texas

Vocational Nursing Education Program

Summary of Request: Consider the proposal from Baptist Health System School of Health Professions Vocational Nursing (VN) Education Program in San Antonio, Texas to establish a track in their VN program for active duty United States Air Force (USAF) Basic Medical Technician Corpsman Program (BMTCP) 4N051 (5 Skill Level) personnel beginning in October 2017. Historical Perspective:

Baptist Health System School of Health Professions (BSHP) has been in operation for over 100 years. They offer programs in Diagnostic Medical Sonography, Health Information Technology, Radiologic Technology, Surgical Technology, Healthcare Management, Vascular Sonography, Computed Tomography, Magnetic Resonance, and Nursing.

Nursing programs include VN, Associate Degree (ADN), LVN to ADN, Registered Nurse to Baccalaureate Degree, and Master’s Degree in Nursing Administration.

The NCLEX-PN® examination pass rate for 2016 was 100% (35/35). Since 2011, the NCLEX-PN® examination pass rates have been above 90%. The NCLEX-RN® examination pass rate for 2016 was 94.57% (174/184).

Administration at BSHP notified Board Staff in March 2017 of a request from USAF leadership in San Antonio, Texas to establish a formal VN education program for their active duty Medical Technicians in San Antonio. Board Staff have worked closely with BSHP VN Program representatives in the development of this proposal.

Due to an analysis by the National Council of State Boards of Nursing (NCSBN) entitled A Comparison of Selected Military Health Care Occupation Curricula with a Standard Licensed Practical/Vocational Nurse Certification as well as a decision by the Missouri Board of Nursing, Board Staff request deliberation of this request by the Board.

Background Information:

The NCSBN Analysis: In 2013, in an effort to support veterans transitioning into the civilian workplace, NCSBN conducted an in-depth analysis of health care specialist/medic, corpsman, and airman curricula to determine equivalency to a standard VN curriculum approved by state boards of nursing. This 2013 analysis concluded the Army VN Program to be the only military training program that is comparable to a standard VN curriculum. In 2016, NCSBN revised its analysis to conclude that the Air Force BMTCP 4N051 (5 Skill Level) is also comparable to a board approved VN curriculum (See Attachment #1).

Decision of Missouri Board of Nursing: Considering the NCSBN Analysis, the Missouri Board evaluated the BMTCP 4N051 (5 Skill Level) curriculum and conducted a comprehensive survey visit. On March 22, 2017, the Missouri Board approved the BMTCP 4N051 (5 Skill Level) program as a practical nursing program in Missouri (See Attachment #2). Therefore, USAF Medical Technicians who complete the program are eligible to apply for licensure by examination in Missouri as well as in states that recognize education programs approved by other boards of nursing.

Request from USAF: A June 21, 2017 communication from Colonel Scott C. Suckow, USAF, MSC, documented the interest of the 59th Medical Wing, the leading medical research, education, deployment, and healthcare delivery organization in the USAF Medical Service, to develop a pilot program with the BSHP VN Department (See Attachment #3). The project was designed to enable enlisted Aerospace Medical Service Technicians, BMTCP 4N051 (5 Skill Level), to voluntarily enroll in a customized training program to augment their previous medical training, and enable them to take and pass the NCLEX-PN® to become practicing LVNs in Texas.

Rationale for track: The USAF 59th Medical Wing partnered with the BSHP VN Department in June 2016

to establish a process to recognize the experience of select active duty military medical technicians, BMTCP 4N051 (5 Skill Level), that would allow the technicians to voluntarily advance their professional development through education designed to earn a VN certificate from a board approved Texas program as well as to meet eligibility requirements to take the NCLEX-PN®.

In order to identify, assess, and determine potential learning needs of the USAF

Medical Technicians, the BSHP VN Department selected the Health Education Systems, Incorporated (HESI) PN Exit Exam to serve as a gap-analysis assessment tool. The HESI PN Exit Exam would not compromise the Assessment Testing Institute (ATI) materials currently utilized by the BSHP VN Program. According to the BSHP VN Program, the HESI PN Exit Exam is professionally recognized as reliable, valid, and predictive of NCLEX® success; incorporates and evaluates critical thinking skills; and is cost effective.

Outcomes of the gap-analysis testing of the 35 randomly selected active duty

members of the Air Force who had completed the BMTCP 4N051 (5 Skill level) program indicated that they needed further preparation in the following areas: (1) pharmacology, and (2) medical-surgical nursing. The BSHP VN curriculum would address the two identified content area deficits by offering the USAF VN students the following four courses totaling 380 contact hours:

o VNSG 1231 Pharmacology (32 didactic clock hours; 2 weeks) o VNSG 1500 Nursing in Health & Illness I (80 didactic clock hours; 2 weeks) o VNSG 1509 Nursing in Health & Illness II (80 didactic clock hours; 2 weeks) o VNSG 1262 Clinical Vocational Nurse VI (188 clinical clock hours; 6 weeks)

Summary of Proposal: BSHP has established an admission process for active duty USAF Medical Technicians,

BMTCP 4N051 (5 Skill Level).

The first cohort will be admitted in October 2017 and consist of 10 – 16 students.

Future enrollment is dependent on the success of the initial cohort.

The program will include 192 didactic contact hours and 188 clinical contact hours to total 380 contact hours.

The BSHP VN Program will assign one full-time faculty member to the first 10 enrolled USAF Medical Technician students. For student numbers up to 16 in the initial cohort, the school will follow Board Rule 214.10 specific to faculty supervision of clinical learning experiences.

USAF Medical Technicians must meet the required standards of all students who are accepted as transfer students entering the BSHP VN Program, including completion of 25% of the total program hours in the BSHP VN Program.

Face-to-face and clinical instruction will be provided five days a week for 12 weeks, excluding holidays.

Clinical learning experiences will be conducted in the Baptist Health System.

The Baptist Health System is funding tuition and fees.

Following graduation and upon licensure, students may serve as staff in the Baptist Health System to develop and maintain clinical proficiency as a part of a Memorandum of Understanding.

Graduates will be awarded a diploma upon completion of the program, advantaging them for further education.

Students will acknowledge the program is voluntary and not required for eligibility for licensure (due to the Missouri Board of Nursing approval).

Students in the track will have access to all student services available to other BSHP students, and a designated staff person will assist them in registration and progression through the program.

The NCLEX-PN® outcomes for graduates from this track will be included in the annual NCLEX-PN® pass rate for the BSHP VN Program.

Pros: BSHP has a well-established VN education program with demonstrated NCLEX-PN®

success, experienced nurse educators, and supportive administration.

The USAF 59th Medical Wing is eager to implement the program as it is designed to expand the clinical skills of the USAF Medical Technicians in order to provide high quality medical care at home bases and in deployed environments.

The program will provide the USAF Medical Technicians a civilian credential that will facilitate their post-military service employment, as envisioned by the National Defense Authorization Act of 2017.

Cons:

The program curriculum is greatly reduced in content and length from the regular BSHP VN Program; therefore, outcomes are unknown.

Rationale for Staff Recommendation and Requirements: The BSHP proposed curriculum recognizes and acknowledges the education and experience of the USAF active duty BMTCP 4N051 (5 Skill Level) personnel and is designed to meet their VN educational needs, without redundancy in the coursework for NCLEX-PN® preparation. Because the new track is a response to a request from USAF leadership in San Antonio, is voluntary, and offers the opportunity for military personnel to earn a certificate from a Texas Board approved vocational nursing education program, Board Staff recommend its approval. The reduced model provides students with intensive coursework and related clinical learning experiences to fill the identified gaps in their previous training. However, because the time frame is abbreviated and formative evaluations will be essential, Board Staff recommend the program submit progress reports at the completion of each course. Staff Recommendation: Move to grant approval to the Baptist Health System School of Health Professions Vocational Nursing Education Program in San Antonio, Texas to establish a track for active duty United States Air Force Basic Medical Technician Corpsman 4NO51 (5 Skill Level) personnel beginning in October 2017, and impose the conditions/requirements in the attached Board Order (See Attachment #4).

A Comparison of Selected Military Health Care Occupation Curricula

with a Standard Licensed Practical/Vocational Nurse Curriculum

NCSBN ANALYSIS:

Mission Statement

The National Council of State Boards of Nursing (NCSBN®) provides education, service and research through collaborative leadership to promote evidence-based regulatory excellence for patient safety and public protection.

Copyright ©2013, Revised 2016 National Council of State Boards of Nursing, Inc. (NCSBN®)

All rights reserved. NCSBN®, NCLEX®, NCLEX-RN®, NCLEX-PN®, NNAAP®, MACE®, Nursys® and TERCAP® are registered trademarks of NCSBN and this document may not be used, reproduced or disseminated to any third party without written permission from NCSBN.

Permission is granted to boards of nursing to use or reproduce all or parts of this document for licensure related purposes only. Nonprofit education programs have permission to use or reproduce all or parts of this document for educational purposes only. Use or reproduction of this document for com-mercial or for-profit use is strictly prohibited. Any authorized reproduction of this document shall display the notice: “Copyright by the National Council of State Boards of Nursing, Inc. All rights reserved.” Or, if a portion of the document is reproduced or incorporated in other materials, such written materials shall include the following credit: “Portions copyrighted by the National Council of State Boards of Nursing, Inc. All rights reserved.”

i

National Council of State Boards of Nursing, Inc. (NCSBN) | Revised 2016

www.ncsbn.org

TABLE OF CONTENTS

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .iiiIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Development of the Standard LPN/VN Curriculum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2The Standard LPN/VN Curriculum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Military Health Care Occupations Examined in this Analysis: Role/Program Descriptions . . . . . . . . . . 5An Analysis of Military Curricula with the Standard LPN/VN Curriculum . . . . . . . . . . . . . . . . . . . . . . . 7An Analysis of the Army 68WM6 LPN Program with the Standard LPN/VN Curriculum . . . . . . . . . . . 9An Analysis of the Air Force BMTCP 4N051 (5 Skill Level) with the Standard LPN/VN Curriculum . . 11Summary of Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Talking Points: Military Training Exception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15


ii www.ncsbn.org

iii


www.ncsbn.org

Acknowledgements

NCSBN gratefully acknowledges the following individuals who have provided assistance with this project.

� Patty Knecht, MS, RN, Director, Chester County Intermediate Unit Practical Nursing Program; Chair, NLN Practical Nurse Ad Hoc Committee

� Mitch Seal, EdD, MEd-IT, RN-BC, Commander, Nurse Corps, U.S. Navy, Navy Professor, Navy Researcher, Director of Performance Management Quality Improvement Medical Education & Training Campus

� Terri Kinsey, Commander, U.S. Navy

� Mary M. Whitehead, Colonel, U.S.A.F., NC, Associate Dean, Academic Support, Medical Education and Training Campus

� Suellyn Masek, MSN, RN, CNOR, Chair, Washington State Nursing Care Quality Assurance Commission

� Lois Hoell, MS, MBA, RN, Washington State Nursing Care Quality Assurance Commission

� Mary Jane Hamilton RN, PhD, Dean and Professor of Nursing, Texas A&M University-Corpus Christi

� Donald L. Parsons, Deputy Director, Department of Combat Medic Training, Medical Education and Training Campus

� Lisa Lutz, President, Solutions for Information Design, LLC

� Veera Pandey, Analyst, Solutions for Information Design, LLC

� Ed Davin, Principal Analyst, Solutions for Information Design, LLC


iv www.ncsbn.org

1


www.ncsbn.org

Introduction

The recently released White House report titled, The Fast Track to Civilian Employment: Streamlining Credentialing and Licensing for Service Members, Veterans and Their Spouses, encourages states to support legislative efforts that will transition veterans into the civilian workplace. The National Council of State Boards of Nursing (NCSBN®) wholeheartedly joins these efforts. We value the contributions veterans have made in the military and acknowledge their training and experience. Our goal is to assist U.S. boards of nursing (BONs) in making licensing decisions that will help veterans safely and competently enter civilian careers in nursing.

Some of the questions that have arisen out of the president’s initiative to transition veterans to civilian careers pertain to the role of the licensed practical/vocational nurse (LPN/VN), including:

� Do Army health care specialists (medics), Navy corpsmen and Air Force airmen have the knowledge, skills and abilities to transition into a career as an LPN/VN directly from their military service?

� What are the differences between military training and LPN/VN education?

� Should veterans be given credit for some of their education and training that will allow them to accelerate through the LPN/VN program?

To assist in answering these questions, NCSBN staff, with consultation from leading experts in the areas of nursing and military education, conducted an in-depth analysis of the health care specialist (medic), corpsman and airman curricula, and compared these with a standard LPN/VN curriculum. The standard LPN/VN curriculum developed for this project is comparable to the LPN/VN curricula approved by U.S. BONs. In addition, NCSBN staff reviewed the Army LPN program and compared it with the standard LPN/VN curriculum; this analysis is provided within this report, along with recommendations and legislative talking points.

NCSBN welcomes any questions related to the information in this report. We are dedicated to assisting BONs in licensing decisions that will allow veterans to enter nursing competently and safely.


2 www.ncsbn.org

Development of the Standard LPN/VN Curriculum

A standard LPN/VN curriculum, comparable to those approved by U.S. BONs, was necessary for this review and analysis. NCSBN staff, with experience in curriculum development and LPN/VN nurse education, consulted a national expert in LPN/VN curriculum development and produced a standard LPN/VN curriculum to be used for these analyses. The consul-tant, Patty Knecht, MS, RN, is currently leading a national initiative to develop a core LPN/VN curriculum.

The elements of the standard LPN/VN curriculum developed for this project are considered minimal core requirements for an LPN/VN program. Although some variation exists across the country and some LPN/VN programs may integrate, present or outline the content differently (i.e., through laboratory exercises, simulation, lecture, etc.), this is a comprehensive stan-dard curriculum that is representative of the minimum didactic and clinical requirements necessary for practical/vocational nursing education in the U.S.

3


www.ncsbn.org

The Standard LPN/VN Curriculum - Essential Content

Anatomy and Physiology

Chemistry of the body, electrolytes and body fluids

Structure and function of cells and tissues

Structure and function of the body systems

Common diseases affecting the body systems and drugs used for treatment

Pharmacology

Pharmacological calculations

Classification of medications

Pharmacokinetics and pharmacodynamics of medications

Nursing considerations in medication administration (six rights/critical thinking)

Nursing Fundamentals

Incidence/prevalence of disease and the health care system

Issues in health care

Therapeutic communication techniques

Cultural considerations in health/illness

Health promotion activities

Infectious process and infection control

Basic nursing care including nutrition (minimum of 35 hours of clinical and 27 hours of lab included in clinical hours total)

Nursing assessment (full vs. focused assessment)

Nursing process/critical thinking

Documentation

Medical-Surgical

IV fluids and calculations of rates and role of LPN/VN

Drug classifications

Understanding diagnostic studies and LPN/VN role

Care of the surgical patient

Care of the oncology patient (death and dying)

Bloodbourne pathogens and standard precautions - integrated

Psychosocial, cultural, spiritual and ethnic considerations with patients - integrated

Community services - integrated

Provide safe and effective care

Physiological implications of disease process - integrated

Obtaining laboratory specimens/interpreting results

Nursing process - integrated

Role of LPN/VN in patient education - integrated

Informed consent - integrated

LPN/VN role in physical assessment - integrated

Care of the older patient - integrated

Care of patients with cardiovascular and peripheral vascular disorders

Care of patients with respiratory disorders

Care of patients with gastrointestinal disorders

Care of patients with endocrine disorders

Care of patients with immune disorders

Care of patients with skin disorders

The Standard LPN/VN Curriculum


4 www.ncsbn.org

The Standard LPN/VN Curriculum - Essential Content

Health promotion activities - integrated

Care of patients with blood and lymphatic disorders

Care of the patient with a reproductive disorder

Care of the patient with a musculoskeletal disorder

Care of the patient with a genitourinary disorder

Care of the patient with a sensory disorder (eye and ear)

Care of the patient with a neurological disorder

Care of the patient with a mental health disorder (could be separate or integrated)

Community health nursing

Gerontological nursing

Maternal and Child Health Nursing

Impact of family in maternal child health - integrated

Ethical issues in perinatal nursing - integrated

Physiological changes during the perinatal period - integrated

Health promotion in maternal child nursing - integrated

Cultural impact - integrated

Community resources - integrated

Normal growth and development

Providing safe patient care during prenatal/labor and delivery and postnatal

Introduction of maternal/child health with review of reproduction

Prenatal and complications

Providing safe patient care to pediatric patients

Labor and delivery

Postnatal with family; women's health care and care of newborn, including congenital anomalies

Normal infant, toddler, preschooler, school-aged and adolescent child

Care of the pediatric patient, including data collection and procedures

Care of child with fluid and electrolyte imbalances

Care of child with sensory or neurologic conditions

Care of child with musculoskeletal disorders

Care of child with respiratory disorders

Care of child with cardiovascular disorders

Care of child with blood, blood-forming organs or lymphatic disorders

Care of child with gastrointestinal disorders

Care of child with genitourinary disorders

Care of child with skin disorders

Care of child with endocrine conditions

Care of child with communicable disease

Care of child with psychosocial disorder

Issues in Nursing

Legal aspects of nursing

Ethical aspects of nursing

5


www.ncsbn.org

Military Health Care Occupations Examined in this Analysis: Role/Program DescriptionsThe following are short descriptions of the military health care occupations that were analyzed and compared with the stan-dard LPN/VN curriculum.

Basic Medical Technician Corpsman Program (Navy HM0000/Air Force BMTCP 4N0X1)

Description of Role: The Basic Medical Technician Corpsman Program prepares service members to function as entry-level medical technicians in fixed and nonfixed medical facilities, performing duties to provide quality emergency nursing and primary care procedures. Graduates demonstrate the ability to comprehend, evaluate and apply information relevant to the role of the basic medical technician; technical proficiency in entry-level skills required to fulfill the role of a basic medical technician; and personal and professional behavior consistent with the expectations of the basic medical technician.

Program Description: The Basic Medical Technician Corpsman Program provides the enlisted with basic knowledge of emergency medicine and nursing care. The program consists of lectures, group activities, demonstrations, hands-on instruc-tion and clinical practice, and may include computer-based or blended learning activities.

Air Force BMTCP 4N031 (3 Skill Level)

Description of Role: This role builds on the skills acquired in BMTCP 4N0X1, which serves as a prerequisite.

Length of Program: Nine months, which consists of a total of 558 program hours.

Program Description: This program provides requisite knowledge, as well as simulated and clinical training in various aspects of emergency, nursing, and primary care. Subjects include medical terminology, anatomy and physiology, Basic Life Support (BLS), Emergency Medical Technician basic curricula, as well as various aspects of nursing and primary patient care. Outcome-based practice and safety techniques are emphasized throughout the program.

Program Prerequisites: Prior to enrollment in the program, the enlisted must complete Air Force BMTCP 4N0X1.

Air Force Independent Duty Medical Technician (IDMT 4N0X1C)

Description of Role: The Air Force independent duty medical technician is an advanced role and is trained to operate a medical aid station at a remote or isolated duty station, provide medical support to a nonmedical field unit or provide medical support to other government agencies and joint service missions. The training is specific to performing emergency medical, dental and surgical procedures to stabilize a patient’s condition until evacuation for definitive care can occur.

Length of Program: Not specified, but approximately 13 weeks based on standard 8-hour training day and total program hours of 517.

Program Description: This program includes specialized training in the following area: obtaining medical histories; exam-ining, assessing, treating and documenting patient care encounters in the absence of a physician; performing emergency medical, dental and surgical procedures to stabilize a patient’s condition until evacuation for definitive care can occur; monitoring medical aspects of special interest programs and health promotions; advanced medication administration; low complexity laboratory procedures; and conducting preventive medicine and food safety inspection in lieu of public health and bioenvironmental health personnel.

Program Prerequisites: Prior to enrollment in this program, the enlisted must have completed Air Force BMTCP 4N0X1 and possess Primary Air Force Specialty Code (PAFSC) 4N051/71 and three years experience practicing as a 4N0XX with two years of direct patient care.

Army Health Care Specialist (68W Army Medic)

Description of Role: The Army health care specialist (medic) is trained to administer emergency care on the battlefield and may also administer limited primary care in battalion aide stations (BAS). Health care specialists (medics) are taught to do rapid assessments and quickly respond to acute injuries and other emergencies. They are experts in evacuation and acquire high level skills to administer care of the severely wounded. The civilian equivalent to this role is an emergency medical technician (EMT).


6 www.ncsbn.org

Length of Course: 16 weeks

Course Description: The Army Medic Course is taught in three distinct phases:

Phase I: Basic EMT Training

Focus is on immediate, emergency care. All participants must pass the National Registry Emergency Medical Technician-Basic (NREMT) examination.

Phase II: Limited Primary Care

This prepares the health care specialist (medic) for serving in a BAS. Coursework covers injuries, illnesses and procedures commonly seen in a BAS. Content covered includes basic physical assessment and history taking, abdominal primary care, basic wound care, eye, ear, nose and throat (EENT) primary care, infection asepsis, sterile technique, injections, medication administration, orthopedic primary care, respiratory primary care, pharmacology, medical documentation and venipuncture.

Phase III: Field Craft

This prepares the health care specialist (medic) for combat. Coursework includes battlefield medicine, combat casualty assessment, battlefield injuries and combat evacuation. Content includes management of shock, traumatic brain injuries, burns, ocular injuries, abdominal trauma, hemorrhage control and vascular access.

Summary of Skills

The 68W Army Health Care Specialist is a registered EMT. He/she has a wide range of skills that help them react to emergencies.

Strengths: physical assessment of acute injuries, limited primary care, advanced level skills from venipuncture to intraosseous fluid replacement and chest tube insertion. Some pharmacology and the principles of medication administration are inte-grated into the course. The health care specialist (medic) does learn about the care of the adult and child with cardiovascular, respiratory, gastrointestinal, endocrine (diabetic), skin, hemodynamic, musculoskeletal, neurological, sensory, and mental health disorder, but the emphasis is placed on emergency care. The goal of this course is passage of the EMT exam and learning to use these skills on the battlefield.

Army Practical Nurse Program (68WM6)

Description of Role: The Army practical nurse specialist supervises or performs preventive, therapeutic and emergen-cy nursing care procedures under the supervision of a physician, nurse or noncommissioned officer. Program instruction includes advanced anatomy and physiology, pathophysiology and appropriate nursing care, expanded use of infection control principles, and pharmacokinetics and medication administration. The nursing process is integrated throughout the program. The clinical rotations include medical-surgical, pre- and post-operative, pediatrics, obstetrics, gerontology, emer-gency room, and critical care settings.

Length of Course: Phase 1 is 8 weeks; Phase 2 is 40 weeks.

Course Description: This is a two-phase course that provides skills and knowledge necessary to become a proficient entry level LPN/VN. Phase 1 is taught at the Academy of Health Sciences Fort Sam Houston and Phase 2 is taught at designated medical treatment facilities.

Course Prerequisites: Prior to enrollment in the course, a student must have a minimum of 24 months of experience as a 68W.

Air Force BMTCP 4N051 (5 Skill Level)

Description of Role: The Air Force corpsman can function independently as a front-line technician and initial trainer.

Length of Program: Approximately 2 1/2 years.

Program Description: After completion of the initial (4N0X1) and 3 skill level (4N031) programs, the 5 skill level program consists of additional on-the-job training and completion of specific Career Development Courses.

Program Prerequisites: Prior to enrollment in the program, a student must complete Air Force BMTCP 4N0X1 and 4N031.

7


www.ncsbn.org

AN ANALYSIS OF MILITARY CURRICULA WITH THE STANDARD LPN/VN CURRICULUM

Key:0 = Military curriculum does not meet requirement1 = Military curriculum partially meets requirement2 = Military curriculum meets requirement

Standard LPN/VN Curriculum - Essential Content

Military Occupations

Navy HM0000Air Force

BMTCP 4N0X1

Air Force 4N031 (3 Skill

Level)

Air Force IDMT 4N0X1C

Army Medic 68W Healthcare Specialist


Chemistry of the body, electrolytes and body fluids 1 1 1 2 1

Structure and function of cells and tissues 1 1 1 2 1

Structure and function of the body systems 1 1 1 2 1

Common diseases affecting the body systems and drugs used for treatment

1 1 1 21

Pharmacology

Pharmacological calculations 2 2 1 2 2

Classification of medications 2 2 1 2 1

Pharmacokinetics and pharmacodynamics of medications 0 0 1 1 1

Nursing considerations in medication administration (six rights/critical thinking)

1 1 1 2 1


Incidence/prevalence of disease and the health care system 0 0 2 1 0

Issues in health care 0 0 2 0 0

Therapeutic communication techniques 1 1 2 1 2

Cultural considerations in health/illness 1 1 1 1 2

Health promotion activities 1 0 2 0 0

Infectious process and infection control 1 1 1 1 2


1 1 2 1 Assess skills

Nursing assessment (full vs. focused assessment) 1 1 2 1 1

Nursing process/critical thinking 1 1 2 1 0

Documentation 1 1 1 1 1

Medical-Surgical

IV fluids and calculations of rates and role of LPN/VN 1 1 1 1 2

Drug classifications 2 2 1 2 1

Understanding diagnostic studies and LPN/VN role 1 1 2 1 1

Care of the surgical patient 1 1 1 1 1

Care of the oncology patient (death and dying) 1 1 1 1 0

Bloodbourne pathogens and standard precautions - integrated 1 1 1 1 2

Psychosocial, cultural, spiritual and ethnic considerations with patients - integrated

1 1 2 1 1

Community services - integrated 0 0 2 0 0

Provide safe and effective care 2 2 2 2 2

Physiological implications of disease process - integrated 1 1 1 2 1

Obtaining laboratory specimens/interpreting results 1 1 1 1 2

Nursing process - integrated 0 0 2 0 0

Role of LPN/VN in patient education - integrated 0 0 2 0 0

Informed consent - integrated 2 2 1 2 0

LPN/VN role in physical assessment - integrated 1 1 2 1 2


8 www.ncsbn.org






BMTCP 4N0X1


Level)



Care of the older patient - integrated 1 1 1 1 0

Care of patients with cardiovascular and peripheral vascular disorders 1 1 2 2 1

Care of patients with respiratory disorders 1 1 2 2 1

Care of patients with gastrointestinal disorders 1 1 2 2 1

Care of patients with endocrine disorders 1 1 2 2 1

Care of patients with immune disorders 1 1 2 1 0

Care of patients with skin disorders 1 1 2 2 2

Health promotion activities - integrated 1 0 1 0 0

Care of patients with blood and lymphatic disorders 0 0 2 2 0

Care of the patient with a reproductive disorder 1 1 2 2 0

Care of the patient with a musculoskeletal disorder 1 1 2 2 1

Care of the patient with a genitourinary disorder 1 1 2 2 0

Care of the patient with a sensory disorder (eye and ear) 2 2 2 2 1

Care of the patient with a neurological disorder 1 1 2 2 1

Care of the patient with a mental health disorder (could be separate or integrated)

1 1 2 2 1

Community health nursing 0 0 2 0 0

Gerontological nursing 1 1 1 1 0


Impact of family in maternal child health - integrated 0 0 2 0 0

Ethical issues in perinatal nursing - integrated 0 0 2 0 0

Physiological changes during the perinatal period - integrated 0 0 2 0 0

Health promotion in maternal child nursing - integrated 0 0 2 0 0

Cultural impact - integrated 0 0 2 0 0

Community resources - integrated 0 0 0 0 0

Normal growth and development 1 1 2 1 2

Providing safe patient care during prenatal/labor and delivery and postnatal

0 0 2 0 1

Introduction of maternal/child health with review of reproduction 0 0 2 0 0

Prenatal and complications 0 0 2 0 0

Providing safe patient care to pediatric patients 0 0 2 0 2

Labor and delivery 0 0 2 0 2

Postnatal with family; women's health care and care of newborn, including congenital anomalies

0 0 2 0 0

Normal infant, toddler, preschooler, school-aged and adolescent child 0 0 2 0 0

Care of the pediatric patient, including data collection and procedures 0 0 2 0 2

Care of child with fluid and electrolyte imbalances 0 0 0 0 1

Care of child with sensory or neurologic conditions 0 0 2 0 1

Care of child with musculoskeletal disorders 0 0 2 0 1

Care of child with respiratory disorders 0 0 2 0 1

Care of child with cardiovascular disorders 0 0 2 0 1

9


www.ncsbn.org






BMTCP 4N0X1


Level)



Care of child with blood, blood-forming organs or lymphatic disorders 0 0 2 0 0

Care of child with gastrointestinal disorders 0 0 2 0 1

Care of child with genitourinary disorders 0 0 2 0 0

Care of child with skin disorders 0 0 2 0 1

Care of child with endocrine conditions 0 0 2 0 1

Care of child with communicable disease 0 0 2 0 1

Care of child with psychosocial disorder 0 0 2 0 1

Issues in Nursing

Legal aspects of nursing 1 1 2 1 0

Ethical aspects of nursing 1 1 2 1 0

AN ANALYSIS OF THE ARMY 68WM6 LPN PROGRAM WITH THE STANDARD LPN/VN CURRICULUM


Standard LPN/VN Curriculum - Essential Content Army 68WM6


Chemistry of the body, electrolytes and body fluids 2

Structure and function of cells and tissues 2

Structure and function of the body systems 2

Common diseases affecting the body systems and drugs used for treatment 2

Pharmacology

Pharmacological calculations 2

Classification of medications 2

Pharmacokinetics and pharmacodynamics of medications 2

Nursing considerations in medication administration (six rights/critical thinking) 2


Incidence/prevalence of disease and the health care system 2

Issues in health care 2

Therapeutic communication techniques 2

Cultural considerations in health/illness 2

Health promotion activities 2

Infectious process and infection control 2


2

Nursing assessment (full vs. focused assessment) 2

Nursing process/critical thinking 2

Documentation 2


10 www.ncsbn.org




Medical-Surgical

IV fluids and calculations of rates and role of LPN/VN 2

Drug classifications 2

Understanding diagnostic studies and LPN/VN role 2

Care of the surgical patient 2

Care of the oncology patient (death and dying) 2

Bloodbourne pathogens and standard precautions - integrated 2

Psychosocial, cultural, spiritual and ethnic considerations with patients - integrated 2

Community services - integrated 2

Provide safe and effective care 2

Physiological implications of disease process - integrated 2

Obtaining laboratory specimens/interpreting results 2

Nursing process - integrated 2

Role of LPN/VN in patient education - integrated 2

Informed consent - integrated 2

LPN/VN role in physical assessment - integrated 2

Care of the older patient - integrated 2

Care of patients with cardiovascular and peripheral vascular disorders 2

Care of patients with respiratory disorders 2

Care of patients with gastrointestinal disorders 2

Care of patients with endocrine disorders 2

Care of patients with immune disorders 2

Care of patients with skin disorders 2

Health promotion activities - integrated 2

Care of patients with blood and lymphatic disorders 2

Care of the patient with a reproductive disorder 2

Care of the patient with a musculoskeletal disorder 2

Care of the patient with a genitourinary disorder 2

Care of the patient with a sensory disorder (eye and ear) 2

Care of the patient with a neurological disorder 2

Care of the patient with a mental health disorder (could be separate or integrated) 2

Community health nursing 2

Gerontological nursing 2


Impact of family in maternal child health - integrated 2

Ethical issues in perinatal nursing - integrated 2

Physiological changes during the perinatal period - integrated 2

Health promotion in maternal child nursing - integrated 2

Cultural impact - integrated 2

Community resources - integrated 2

Normal growth and development 2

Providing safe patient care during prenatal/labor and delivery and postnatal 2

Introduction of maternal/child health with review of reproduction 2

11


www.ncsbn.org




Prenatal and complications 2

Providing safe patient care to pediatric patients 2

Labor and delivery 2

Postnatal with family; women's health care and care of newborn, including congenital anomalies 2

Normal infant, toddler, preschooler, school-aged and adolescent child 2

Care of the pediatric patient, including data collection and procedures 2

Care of child with fluid and electrolyte imbalances 2

Care of child with sensory or neurologic conditions 2

Care of child with musculoskeletal disorders 2

Care of child with respiratory disorders 2

Care of child with cardiovascular disorders 2

Care of child with blood, blood-forming organs or lymphatic disorders 2

Care of child with gastrointestinal disorders 2

Care of child with genitourinary disorders 2

Care of child with skin disorders 2

Care of child with endocrine conditions 2

Care of child with communicable disease 2

Care of child with psychosocial disorder 2

Issues in Nursing

Legal aspects of nursing 2

Ethical aspects of nursing 2

AN ANALYSIS OF THE AIR FORCE BMTCP 4N051 (5 SKILL LEVEL) WITH THE STANDARD LPN/VN CURRICULUM


Standard LPN/VN Curriculum - Essential Content Air Force BMTCP 4N051 (5 Skill Level)


Chemistry of the body, electrolytes and body fluids 2

Structure and function of cells and tissues 2

Structure and function of the body systems 2

Common diseases affecting the body systems and drugs used for treatment 2

Pharmacology

Pharmacological calculations 2

Classification of medications 2

Pharmacokinetics and pharmacodynamics of medications 2

Nursing considerations in medication administration (six rights/critical thinking) 2


Incidence/prevalence of disease and the health care system 2

Issues in health care 2

Therapeutic communication techniques 2


12 www.ncsbn.org




Cultural considerations in health/illness 2

Health promotion activities 2

Infectious process and infection control 2


2

Nursing assessment (full vs. focused assessment) 2

Nursing process/critical thinking 2

Documentation 2

Medical-Surgical

IV fluids and calculations of rates and role of LPN/VN 2

Drug classifications 2

Understanding diagnostic studies and LPN/VN role 2

Care of the surgical patient 2

Care of the oncology patient (death and dying) 2

Bloodbourne pathogens and standard precautions - integrated 2

Psychosocial, cultural, spiritual and ethnic considerations with patients - integrated 2

Community services - integrated 2

Provide safe and effective care 2

Physiological implications of disease process - integrated 2

Obtaining laboratory specimens/interpreting results 2

Nursing process - integrated 2

Role of LPN/VN in patient education - integrated 2

Informed consent - integrated 2

LPN/VN role in physical assessment - integrated 2

Care of the older patient - integrated 2

Care of patients with cardiovascular and peripheral vascular disorders 2

Care of patients with respiratory disorders 2

Care of patients with gastrointestinal disorders 2

Care of patients with endocrine disorders 2

Care of patients with immune disorders 2

Care of patients with skin disorders 2

Health promotion activities - integrated 2

Care of patients with blood and lymphatic disorders 2

Care of the patient with a reproductive disorder 2

Care of the patient with a musculoskeletal disorder 2

Care of the patient with a genitourinary disorder 2

Care of the patient with a sensory disorder (eye and ear) 2

Care of the patient with a neurological disorder 2

Care of the patient with a mental health disorder (could be separate or integrated) 2

Community health nursing 2

Gerontological nursing 2

13


www.ncsbn.org





Impact of family in maternal child health - integrated 2

Ethical issues in perinatal nursing - integrated 2

Physiological changes during the perinatal period - integrated 2

Health promotion in maternal child nursing - integrated 2

Cultural impact - integrated 2

Community resources - integrated 2

Normal growth and development 2

Providing safe patient care during prenatal/labor and delivery and postnatal 2

Introduction of maternal/child health with review of reproduction 2

Prenatal and complications 2

Providing safe patient care to pediatric patients 2

Labor and delivery 2

Postnatal with family; women's health care and care of newborn, including congenital anomalies 2

Normal infant, toddler, preschooler, school-aged and adolescent child 2

Care of the pediatric patient, including data collection and procedures 2

Care of child with fluid and electrolyte imbalances 2

Care of child with sensory or neurologic conditions 2

Care of child with musculoskeletal disorders 2

Care of child with respiratory disorders 2

Care of child with cardiovascular disorders 2

Care of child with blood, blood-forming organs or lymphatic disorders 2

Care of child with gastrointestinal disorders 2

Care of child with genitourinary disorders 2

Care of child with skin disorders 2

Care of child with endocrine conditions 2

Care of child with communicable disease 2

Care of child with psychosocial disorder 2

Issues in Nursing

Legal aspects of nursing 2

Ethical aspects of nursing 2


14 www.ncsbn.org

Summary and Recommendations

1. After an extensive review of health care specialist (medic), corpsman and airman curricula and comparing it with a standard LPN/VN curriculum, significant differences in content were identified. These differences preclude granting an LPN/VN license to veterans specialized in these areas without additional practical/vocational nurse coursework and clinical experience.

2. For veterans with training and experience as health care specialists (medics), corpsmen and airmen, civilian BON-approved LPN/VN programs should develop bridge programs that are based on individual assessments of each veteran and geared towards helping these individuals acquire the knowledge, skills and abilities needed to practice as an LPN/VN safely without repeating previously acquired content.

3. Each veteran will be leaving the military with varying levels of experience. Some have inserted chest tubes and per-formed other small surgical procedures, while others have little, if any, experience doing these procedures and instead had other types of responsibilities (nonhealth care related) during their military service. Therefore, it is recommended that the knowledge, skills and abilities of all veterans entering an LPN/VN program should be formally evaluated/assessed prior to beginning a program. If proficiency is demonstrated, this should be accounted for in the LPN/VN program to assist in accelerating the education process.

4. After successful completion and graduation from the LPN/VN program, the veteran must pass the NCLEX-PN® Examination prior to licensure as an LPN/VN.

5. While the courses offered in military programs are comprehensive and rigorous, a veteran who has been a health care specialist (medic), corpsman or airman must learn the role of the nurse, the nursing process and the science of nursing care. The veteran must learn the role of the LPN/VN, the scope of practice and the principles of delegation in order to practice competently and safely. This is acquired through formal education, both clinical and didactic, and must be integrated throughout the course of study.

6. The Army LPN Program is comparable to a standard LPN/VN program approved by BONs.

7. The Air Force BMTCP 4N051 (5 Skill Level) is comparable to a standard LPN/VN program approved by BONs.

15


www.ncsbn.org

Talking Points: Military Training ExceptionNCSBN supports veterans entering the nursing profession. We would like these hard working individuals to succeed and experience long and rewarding careers in the field of nursing.

� The roles and responsibilities of registered nurses (RNs) and licensed practical/vocational nurses (LPN/VNs) are different from that of health care specialists (medics), corpsmen and airmen. Thus, the training for these military occupations is different from that of nursing education programs.

Even within the military, RNs and LPNs have separate roles and responsibilities from health care specialists (medics), corpsmen or airmen. The military requires RNs working in military facilities to hold a bachelor’s degree in nursing and meet all the requirements of a civilian nursing program approved by a board of nursing (BON). A health care specialist (medic) or corpsman can only become an RN in the military by completing an RN program. Educational exemptions are not offered based on experience or another type/level of training.

Currently, the Army and the Air Force are the only branches of service with an LPN occupational specialty. Certain MOS 68W soldiers (Army combat medics) and AFSC airmen can attend a course to become an entry level LPN. Students are required to sit for the NCLEX-PN® Examination and obtain licensure as an LVN. Thus, LPNs in the Army receive a substantial amount of additional education above and beyond training as a health care specialist (medic), corpsman or airman.

� LPN/VN education is different than the training received by health care specialists (medics), corpsmen or airmen.

After an extensive review of the health care specialist (medic), corpsman and airman curricula and comparing it with a standard LPN/VN curriculum, significant differences in content were identified. The military occupations lack content in the nursing process, health promotion and prevention, care of the pediatric patient, care of the obstetric patient, care of the older adult/geriatric patient, and chronic care management. In addition, the role of the LPN/VN is different from the military health care occupations cited in this report. The veteran needs time to learn a new scope of practice, acclimate to the role of an LPN/VN, and learn how to think and act like an LPN/VN. For those who have only worked on the battlefield, coursework will be needed on the health care delivery system, including hospital systems and long-term care. For a full listing of the educational differences, please review “NCSBN Analysis: A Comparison of Selected Military Health Care Occupation Curricula with a Standard Licensed Practical/Vocational Nurse Curriculum.”

� Allowing health care specialists (medics)/corpsmen/airmen to bypass educational requirements and sit unpre-pared for the NCLEX® is costly and can undermine test taker confidence.

� Graduation from a BON approved LPN/VN program is mandatory for all individuals wishing to be licensed as LPN/VNs; however, some LPN/VN content may overlap and be repetitive of the military occupation program content. NCSBN supports and encourages the development of LPN/VN bridge programs that allow health care specialists (medics), corpsmen and airmen credit for the knowledge, skills, and abilities they acquired in the military and focus content on gaps in knowledge, the nursing process and differences between the military and LPN/VN roles and scope of practice.

The Army and the Air Force are the only branches of the military to offer an LPN program that provides the training necessary to be licensed as a practical/vocational nurse. NCSBN recommends the development of civilian LPN/VN bridge programs geared towards assisting veterans in mastering the knowledge, skills and abilities needed to practice safely without repeating previously acquired content.

NCSBN represents U.S. BONs and supports the initiative to transition veterans to careers in nursing. NCSBN is working with many groups to address different aspects of this project and should be involved in any discussions regarding this endeavor so that it can assist in assuring veterans have a safe and smooth transition into a career in nursing.

Agenda Item: 3.2.8. Attachment #2

Board Meeting: July 2017

Press Release Missouri State Board of Nursing Approval of Air Force Program

Missouri Board of Nursing Rules Recognizing Air Force Program Now Effective Missouri is the first state in the nation to formally approve the program.

Jefferson City, Mo. - At a meeting held in Jefferson City, Missouri on March 22, 2017, the Missouri State Board of Nursing voted unanimously to approve the Air Force BMTCP 4N051 (5 Skill Level) program as a practical nurse program. Applications are now being accepted to allow these service members to become licensed in caring for Missourians. The timing of this new licensure category corresponds to the National Nurses Day celebration held annually on May 6 that raises awareness of the important role nurses play in society.

Colonel Christine A. Kress, Master Sergeant David M. Carr and Lieutenant Colonel Dianne M. Stroble stationed at Whiteman Air Force Base testified before the board on behalf of Major General Dorothy Hogg, the Air Force Deputy Surgeon General and Chief of the Nurse Corps, Chief Jessica Liebgott, Aerospace Medical Services/Surgical Services Career Field Manager, and the 6,800 active duty and 5,700 Guard and Reserve enlisted nursing personnel. Colonel Kress outlined the benefit for enlisted medics to take the LPN exam on the basis of academic accomplishment and clinical skills validation. Colonel Kress further said "Whiteman alone has 30 medics ready to sit for the board. Today, they are boots on the ground at the 509 Medical Group caring for our nations' Airmen, their family members and retirees."

As a result of the Board of Nursing action, Missouri is the first state to approve the Air Force's program. Three other states recognize this program as equivalent, but Missouri is the first state to formally approve the program leading to increased educational and job opportunities for service members, veterans and families.

Bibi Schultz, the Board of Nursing's Director of Education, represents Missouri on the Multi-State Collaborative on Military Credit Steering Committee (MCMC) and was instrumental in championing this action. The National Council of State Boards of Nursing (NCSBN) 2016 analysis of military health care programs recognized this program as comparable to any standard LPN program approved by licensing boards. The Missouri Board agreed and enthusiastically approved the proposal.

Missouri Board of Nursing Director Lori Scheidt said "We are very excited to make this landmark announcement during National Nurses Week. We are honored to work with all military branches to strengthen access to quality healthcare to the citizens of Missouri and to assisting veterans in transitioning into civilian careers. Governor Greitens' Administration expedited approval of the regulations that allows these individuals to apply for licensure. The regulation is now effective and military personnel or veterans who have successfully completed the Air Force BMTCP 4N051 (5 Skill Level or above) program can now apply for a LPN license in Missouri."

Agenda Item: 3.2.8. Attachment #4

Board Meeting: July 2017 DRAFT LETTER July 24, 2017 Donna Wallis, MBA, MSN, RN, Director Vocational Nursing Education Program Baptist Health System School of Health Professions 8400 Datapoint Drive San Antonio, Texas 78229-3234 Dear Ms. Wallis: At the July 20, 2017 meeting, the members of the Texas Board of Nursing discussed the request to establish a track for active duty United States Air Force Basic Medical Technician Corpsman 4N051 (5 Skill Level) personnel. Based upon the discussion and review of information, it was the decision of the Board to accept the request from the Baptist Health System School of Health Professions Vocational Nursing Education Program in San Antonio, Texas to establish a track for active duty United States Air Force Basic Medical Technician Corpsman 4N051 (5 Skill Level) personnel beginning in October 2017 and impose the conditions/requirements in the attached Board Order.

Requirements are mandatory criteria based upon program assessment directly related to the rules that must be addressed in the manner prescribed.

We wish you success with the program. If you have questions, or if we may offer assistance, please contact Board Staff at 512-305-7660.

Sincerely, Katherine A. Thomas, MN, RN, FAAN Executive Director Copy: Patricia E. Alvoet, EdD, MSN, RN-BC, Interim President Colonel Scott C. Suckow, USAF, MSC, Administrator, 59th Medical Wing

BEFORE THE TEXAS BOARD OF NURSING

***********************************

ORDER OF THE BOARD

In the Matter of Baptist Health System School of Health Professions Vocational Nursing Education Program In San Antonio, Texas A public meeting of the Texas Board of Nursing, hereinafter referred to as the Board, was held on July 20, 2017, 333 Guadalupe, Tower II, Room 225, Austin, Texas, to consider approval of the request from Baptist Health System School of Health Professions Vocational Nursing Education Program in San Antonio, Texas to establish a track for active duty United States Air Force Basic Medical Technician Corpsman 4N051 (5 Skill Level) personnel. After review and due consideration of the filed materials and history of the program, including currently being on Full Approval status, as well as the presentation by representatives from Baptist Health System School of Health Professions Vocational Nursing Education Program in San Antonio, Texas, and other interested parties, if any, the Board hereby APPROVES the request to establish a track for active duty United States Air Force Basic Medical Technician Corpsman 4N051 (5 Skill Level) personnel and imposes the following conditions/requirements: 1. The program shall not admit more than one (1) cohort of sixteen (16) students in October

2017. 2. The program shall submit for Board Staff approval a list of the number of all enrolled students.

The total enrollment number shall be submitted to Board Staff no later than ten (10) days following the date of the end of each course.

3. The program shall submit for Board Staff approval a list of each nursing course outcome (pass or fail) for all enrolled students. The de-identified student outcome list shall be submitted to Board Staff no later than ten (10) days following the date of the end of each course.

4. The program shall submit for Board Staff approval a comprehensive Remediation Plan to timely assist unsuccessful students.

5. The program shall submit for Board Staff approval a plan for students who are unable to pass a course(s).

Entered this 20th day of July, 2017

____________________________ Katherine A. Thomas, MN, RN, FAAN

Executive Director On behalf of the Texas Board of Nursing

Agenda Item: 3.2.8. Prepared by: V. Ayars/J. Hooper/K ... · Systems, Incorporated (HESI) PN Exit...

Documents

Transcript of Agenda Item: 3.2.8. Prepared by: V. Ayars/J. Hooper/K ... · Systems, Incorporated (HESI) PN Exit...